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• W2946891073 abstract "Background Both propofol and volatile anesthetics are commonly used for maintenance of anesthesia in patients undergoing neurosurgical procedures. The effects of these two classes of drugs on cerebral hemodynamics have been compared in many clinical trials The objectives of this review were to evaluate the cerebral hemodynamic effects, operative conditions, recovery profiles, postoperative complications, and neurological outcomes of propofolbased vs volatile-based anesthesia for craniotomy. Methods MEDLINE, EMBASE TM , Cochrane, and other relevant databases were searched for randomized controlled trials that compared propofol-maintained anesthesia with volatile-maintained anesthesia in adult patients undergoing elective craniotomy. The primary outcome measure was the intraoperative brain relaxation score. Secondary outcome measures included intraoperative cerebral hemodynamics (intracranial pressure [ICP], cerebral perfusion pressure [CPP]), cardiovascular changes, recovery profiles, postoperative complications, and clinical outcomes (neurological morbidity, mortality, quality of life). A metaanalysis was conducted using a random effects model to compare the outcomes of the two anesthetic techniques. Results Fourteen studies (1,819 patients) met inclusion criteria and were analyzed. Brain relaxation scores were similar between the two groups after dural opening; however, ICP was lower (weighted mean difference of -5.2 mmHg; 95% confidence interval -6.81 to -3.6) and CPP was higher (weighted mean difference of 16.3 mmHg; 95% confidence interval 12.2 to 20.46) in patients receiving propofol-maintained anesthesia. Postoperative complications and recovery profiles were similar between the two groups, except for postoperative nausea and vomiting being less frequent with propofol-maintained anesthesia. There were inadequate data to perform a metaanalysis on clinical outcome. Conclusion Propofol-maintained and volatile-maintained anesthesia were associated with similar brain relaxation scores, although mean ICP values were lower and CPP values higher with propofol-maintained anesthesia. There are inadequate data to compare clinically significant outcomes such as neurological morbidity or mortality." @default.
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• W2946891073 date "2014-01-01" @default.
• W2946891073 modified "2023-09-27" @default.
• W2946891073 title "Comparison of propofol and volatile agents for maintenance of anesthesia during elective craniotomy procedures: systematic review and meta-analysis Comparaison entre propofol et agents volatils pour le maintien de l'anesthesie pendant les interventions de craniotomie non urgentes : revue methodique et meta-analyse" @default.
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